We have had many questions circulating back to me as to how we will handle the initial & long-term response to the Covid-19. We are watching the recommendations from the ADA, TDA, State of Tx officials, CDC, WHO and City of San Antonio closely, and obviously this is a very fluid situation. Having protocol in place as we consider safety of you our staff and of our patients is critical as we work in an industry with elevated risks compared to the general public. Below are our most current guidelines and information.
Patient evaluation
• There will be a sign posted on the front door that if anyone has symptoms of Fever, Cough, or Shortness of breath, to please not enter and call the front office from their phone.
• Patient questionnaire: Upon patient’s arrival, we will give patients a questionnaire to assess them for Covid-19 symptoms. Familiarize yourself with the questions and if you have patients which answer “Yes” please use caution and have the doctor discuss with the patient further prior to any further interaction.
• We have thermal thermometers which will be used for anyone with even the slightest hint of respiratory distress and this will be recorded as a vital sign.
• Coughing: Anyone who is coughing should be given a mask and asked to seek medical attention from their physician or urgent care. We will not be able to treat them.
Protective Personal Equipment (PPE)
We have diligently been trying to stock enough masks, gloves, gowns from multiple suppliers for the past several weeks and we currently are limited on what we can purchase.
• Masks: We have been ordering the maximum number of masks from different suppliers and if we limit usage and are conservative, we likely will have enough.
• Gloves: are still available, but demand is surging.
• Purell/Hand Sanitizer: We are having some difficulty obtaining Purell/hand sanitizer, but please use soap and water, following CDC hand washing guidelines, as well as using the Avagard-D medicated lotions.
• Gowns: In short supply due to a significant manufacturer’s recall before COVID-19. Do not give to patients because they are cold, and be conservative
B/c of the expected supply shortage, we ask that you plan your appointment very well. Lists of needed supplies for each procedure should be check listed for verification, utilize limited changing of gloves, using barriers on mouse and keyboards, etc…
Infection Control
Because COVID can stay alive on surfaces for 24+ hours, it is critical to keep all surfaces clean and sanitized. We will be removing all magazines from the front lobby, as well as anything but bare essentials that others can touch, including iPads. It appears that Cavicide, 62-71% ethanol and 0.1% Sodium Hypochlorite are all effective at killing the virus. We are still able to order Cavicide, so we need to be excessive about a high level of infection control throughout the office.
• Front & Admin office: please wipe all counters, door handles, phones, bathrooms multiple times per day.
• Clinical floor: please wipe abundantly the dental equipment, Xray equipment, counters, lights, chairs, curing lights, cabinet handles, and cabinets. Use normal wrapping and disposables, including plastic on computers and mouse. Please also use the same measures in the staff lounge and business offices. Those closing should do a final Clorox wipe of all sterile center counters, autoclaves, lab and lube station.
• Hand washing MUST be frequent and between every patient. Please let patients see you doing this.
• We will be keeping the office colder for better ventilation, so plan accordingly.
• We will begin asking patients to do a pre-procedure rinse with Colgate Peroxyl as recommended
Employee illness
If you begin to have symptoms of fever, chills, shortness of breath, cough, respiratory distress, please let us know immediately. You cannot report to work with a fever greater than 100.4F It is recommended that you call your physicians office prior to physically going to the office. If you don’t have a physician, call a nearby urgent care prior to going in. The San Antonio hotline for advice is 210-207-5779 (Monday-Friday 8:00 a.m. – 5:00 p.m.). Information for the public is also available at: https://www.sanantonio.gov/health/2019ncoronavirus.
Dental Industry & Worsening of Pandemic
Because of the nature of our work, the aerosols we create, and the means of spread of the virus, we may need to take serious steps in the coming weeks regarding elective and non-emergency treatment. We assume that any type of shutdown will be region specific.
Assuming the spread of the virus continues on its current path, we may have serious decisions to make as your employer and as an industry. Once community spread propagates in San Antonio, we may need to consider moving away from elective treatment all together. Likely, we will continue to offer emergency treatment as long as possible, unless authorities fully shut down our service as an industry. You may need to make a personal decision about your personal health and personal risks of working in our industry and I am available to discuss at any time. We are aware that your livelihood and paycheck are critical for you and we will do everything we can to help. We are closely monitoring developments of small business support in regard to payroll, discussing with MB2 options, and as information becomes available, we will relay it.
Let’s be as safe as possible and support one another during this unprecedented time. We will get through this and pray for resolve for all of us.
References:
1) CDC Situation Summary: https://www.cdc.gov/coronavirus/2019-ncov/index.html
2) CDC Infection control: https://www.cdc.gov/coronavirus/2019-ncov/infection-control/
3) ADA: http://ADA.org/virus
4) Journal of Oral Medicine: COVID in Dental workspace: https://www.nature.com/articles/s41368-020-0075-9
